We had our quarterly hospital visit yesterday. I dread these for 2 reasons, 1) the hbA1C result (its like being in school and waiting for exam results) and 2) getting a telling off by the consultant about lows.
K has been having a lot of lows lately, well not so much in the last few weeks as over the last few months. Recently we've been testing her a lot more at night and finding some horrible lows.
K's A1C was 7.0%, really good considering she's on MDI's (down from 7.6%); but not so good if a low A1C is just as a result of lows....
As expected the doctor started tut-tutting our control. She mellowed a little when i explained that a lot of the lows are at night & previously we didnt know about them (45% of lows in December were between 11pm & 7am, and mainly around 2 am).
But she said the number of lows is still too high and I agree with her. But how many is normal if you're trying to keep as tight a controll as possible?
This is probably going to reflect badly on our level of control but here's some stats;
K's % of tests in each category over the 3 months before each visit were
So, very high has gone down by 10% and normal up to 43%. But lows have increased from 9% to 12% of all readings and we need to tackle this....
To combat the nightime we've been changed from Insultart to Levamir as the doc thinks its less spiky when kicking in,. we are also dropping the nightime dose to 2 units (from 3.5-4) to see how K gets on......
p.s. I asked about the pump & the doctor had a lovely interaction with K, getting K's thoughts on the pump. The doc feels we're ready for the pump & are putting in the work necessary for same. We need to talk to M's employer and when M arranges time off work the hospital will try to co-ordinate with supplying a pump (can take a few months). I'm happy to stay on MDI's for a few more months to try to get rid of these lows and try to up the normal rane to over 50% (too ambitious?)
p.p.s. its now 2:30 am and just got a nice reading of 8.1, so no 4am alarm tonight....
K has been having a lot of lows lately, well not so much in the last few weeks as over the last few months. Recently we've been testing her a lot more at night and finding some horrible lows.
K's A1C was 7.0%, really good considering she's on MDI's (down from 7.6%); but not so good if a low A1C is just as a result of lows....
As expected the doctor started tut-tutting our control. She mellowed a little when i explained that a lot of the lows are at night & previously we didnt know about them (45% of lows in December were between 11pm & 7am, and mainly around 2 am).
But she said the number of lows is still too high and I agree with her. But how many is normal if you're trying to keep as tight a controll as possible?
This is probably going to reflect badly on our level of control but here's some stats;
K's % of tests in each category over the 3 months before each visit were
| Jun-Aug | Sep-Dec | ||
| Very High | >13.9 (over 250) | 30% | 20% |
| High | >9.9-13.9 (180 to 250) | 25% | 25% |
| Normal | >3.9-9.9 (70 to 180) | 36% | 43% |
| Low | >3.3 - 3.9 (60 to 70) | 2% | 4% |
| Very Low | <=3.3 (60) | 7% | 8% |
So, very high has gone down by 10% and normal up to 43%. But lows have increased from 9% to 12% of all readings and we need to tackle this....
To combat the nightime we've been changed from Insultart to Levamir as the doc thinks its less spiky when kicking in,. we are also dropping the nightime dose to 2 units (from 3.5-4) to see how K gets on......
p.s. I asked about the pump & the doctor had a lovely interaction with K, getting K's thoughts on the pump. The doc feels we're ready for the pump & are putting in the work necessary for same. We need to talk to M's employer and when M arranges time off work the hospital will try to co-ordinate with supplying a pump (can take a few months). I'm happy to stay on MDI's for a few more months to try to get rid of these lows and try to up the normal rane to over 50% (too ambitious?)
p.p.s. its now 2:30 am and just got a nice reading of 8.1, so no 4am alarm tonight....
I think the insulin your daughter used to be on, is that same one we were on when Elise was on MDI (here it's called NPH). We avoided those overnight lows by feeding Elise a nice lost-lasting, slow-releasing carb. A peanut butter sandwich on whole wheat bread worked perfectly.
ReplyDeleteWe never used Levemir, but I've heard that some people have to split the dose to avoid getting lows at certain times of the day. Elise has a friend that takes a dose in the morning and a dose before bed.
Good luck with the pumping... it has been a rough start for us, but things are starting to turn around.
I used lantus when I was on MDI and I would be low all night long every single night. I used to drink syrup before bed. I never tried it (because I wasn't aware at the time) splitting long acting doses. Half of the dose every 12 hours.
ReplyDeleteNot sure it would have worked but I wish I had tried it.
best of luck to you guys!